There are many influences that can affect how individuals think, behave, and react when confronted with an ethical dilemma. People make decisions throughout their life that are guided by what they have encountered through personal experiences, as well as cultural and spiritual influences. With the cultural diverseness of our Western society, there is more of an “emphasis on self-reliance and individualism” when it comes to nursing (Ludwick, 2000). Respect for human dignity and the importance for an individual to have an active role in making their own health care decisions is an important factor in nursing practice.
In our society, it is important to have control over one’s emotions and desires in relation to personal decisions involving health care. Nurses have an important role in advocating for those that wish to be heard as well as ensuring that the desired care is delivered. At times there is conflict between what a patient wishes and what is considered as ethically correct. As a nurse in the mental health field, it is difficult to be able to classify what the diagnosis of a patient is just as much as identifying the medication for that diagnosis.
Serving alongside some of the veterans that are seen in the mental health clinic sometimes brings about the question if they are receiving the right type of care. There is much stigma placed upon mental health care and when identifying the individual as a veteran, many times their feelings and troubles are generalized. By recognizing this, many veterans within the clinic are followed more closely by outreach calls that ensure patient safety in addition to tracking their overall mental health status. Perhaps there is a personal level of commitment attached to these veterans due to a connection involving combat and its repercussions.
Personal feelings can also hinder a nurse in providing the ‘desired care’ that a patient requests. Because society is so diverse there are many beliefs, either spiritual or cultural, that can conflict with a nurse’s values and morals. For example; it had been identified that a psychotic patient was in dire need for intervention through medication. With this patient’s cultural beliefs, he was unable to follow through with the care suggested. The result of this situation ended with the patient being arrested, placed on hospital hold, and eventually being forced to take these medications. The ethical dilemma entailed nurses and doctors to identify that their obligation was to not only keep the public safe, but to ensure that the patient was safe, thus overriding his personal desires.
Although many medical professionals feel that they know the right or wrong answer based on what they have learned in textbooks, it may not always be the best answer for the patient. There are many events that can affect diverse ways of thinking, which shapes each individual nurse’s practice. After exposure to different cultures, a nurse is able to recognize and begin to appreciate beliefs that are unlike his or her own. Some cultures do not allow an individual to make decisions of their own, sometimes impeding necessary care that can sustain their life. This idea of holding back care is all that the medical professional identifies when confronted with these dilemmas. They are unable to appreciate or fully understand why this individual is being ‘forced’ to refuse care. This is difficult to comprehend when it is so evident about what should be done.
Patients understand and respect the opinion of the health care providers; otherwise they would not be seeking care. It is the nurse’s responsibility to keep each patient from harm in addition to sustaining their dignity and respect. When seeking care, one is identifying that they are unable to tackle the problem alone and is in need of assistance from another. This vulnerability should be respected and the health care provider should include them and all of their values within the plan of care.
There will always be an event or situation that entails a nurse to set aside their personal beliefs and do what is right for the patient in a given situation. Even though some issues can be affected by a nurses own values, the benefits and the consequences should be individually considered. If the patient is of sound mind and is doing no harm to themselves or others, perhaps it is best to allow them to identify what is best for them. It is an obligation to ensure that a patient receives the best care that they deserve.
Burkhardt, M. &. (2008). Ethics & Issues in Contemporary Nursing. Clifton Park: Delmar.
Ludwick, R. &. (2000). Ethics: Nursing Around the World: Cultural Values and Ethical Conflicts. Online Journal of Issues in Nursing. 5 (3), 1-4.
Resource 1: My Nursing Ethic
PASSION: Why am I here?
I have always felt that I am here to help others, regardless of the profession I chose. I had started off as an elementary education major and ended up graduating with my psychology degree. From there I had joined the Army to become a medic to provide care to those who I had fought next to during war time. I found myself wanting to learn more and became a nurse to advocate for patients as well as care for them medically. I lost many friends through deployments and many of them are lost within themselves. I want to be the nurse that not only understands, but listens to what they have to say. I feel very strongly about establishing a rapport with my patients, even if I only speak to them once. I want them to know that there is someone there that they can talk to when the time comes.
MOTIVATION: What moves me to act?
Someone who genuinely needs assistance with a situation, despite how great or how diminutive it may seem. When I hear about how something that has been resolved or attended to because of what I had done, it motivates me even more to continue with my persistence in difficult situations. I find that when there is respect for my profession from providers and others, this also increases my motivation. I find it motivating when I finally am able to assist a patient with positive changes that has been difficult for others to do so in the past. It is always motivating to be successful with a challenging and ‘hard to work with’ patient; all it takes is time, caring and listening. Working alongside others that are motivated also will have an effect on my motivational level.
INSPIRATION: What keeps me in motion?
I am most inspired by my patients. I feel that those that served before, with and after me deserve my undivided attention. Those that are truly searching for help and are motivated to do everything they can to get better, inspire me. I also find that colleges who depend on my knowledge and experience inspire me to become a better and more understanding nurse. I realize that many times, the VA is the only place many veterans can receive care (or even a hot meal); this reminds me that I may be the only one left who will listen.
LOYALTY: Whom do I serve?
Although I am here to assist the providers, I am here to serve the patients that are our country’s veterans. I make myself available and would go the extra mile to ensure they receive the best care and treatment that they deserve. I served alongside many of them during deployments and feel that I can continue to do this by being the best advocate they can have at